Members of Congress are pressuring the Centers for Medicare and Medicaid Services (CMS) to accelerate implementation of a law aimed at speeding claims settlements that require CMS approval.
Letters to CMS, sent by 11 members of the House and eight members of the Senate at the request of the Medicare Advocacy Recovery Coalition (MARC), deal with implementation of the SMART Act, or the Strengthening Medicare and Repaying Taxpayers Act, which seeks to reduce the time required to close insurance claims in cases where Medicaid or Medicare funds may have been used to provide care pending settlement of auto or workers’ compensation claims.
The SMART Act aims to correct problems associated a 2007 law, the Medicare Secondary Payment Act (MSP), that strengthened CMS’ ability to require people under Medicare or Medicaid who used that insurance to pay medical bills, but were later reimbursed by other payers.
CMS is implementing the SMART Act by establishing a web portal through which interested parties can to receive approval for a proposed settlement. But David Farber, a Washington lawyer who represents MARC, says CMS is way behind in following the timetable mandated by law to implement the changes, including the portal.
He notes CMS has issued a final interim rule that gives it until 2016 to implement the law, even though the portal is supposed to be in place by October 2013.
The letters demand that CMS act “promptly and swiftly” to implement the changes required by the law. They state, “While we appreciate the agency’s concerns over data privacy, every month of delay in establishing the online portal costs tens of millions of dollars in delayed repayments and lost settlements.
“We urge you to complete the development of a full and robust portal, to not only enhance Medicare recoveries, but to ease compliance for regulated entities and beneficiaries.”
Greg McKenna, MARC vice chairman, says “Timely implementation of the SMART Act holds the promise of improving the Medicare process for thousands of Medicare beneficiaries, which in turn can help provide millions to the Medicare Trust Fund faster. This solution, if implemented by CMS in accord with the law, is good for companies large and small, as well as beneficiaries, throughout America.”